Indicators developed to evaluate the international framework convention on tobacco control in Iran; a grounded theory study

This study aimed to develop indicators for evaluating the implementation of The Framework Convention on Tobacco Control [FCTC] in Iran. We used the "grounded theory" framework. Totally, 265 policy-makers, stakeholders, and community members were recruited by purposeful sampling in 2008. After analyzing the gathered data, 251 indicators, including 82 indicators as "applied indicators", were derived from second-level codes for three groups. A suitable evaluation questionnaire can be designed based on the extracted indicators for policy makers, stakeholders, and the community to follow the implementation of the FCTC in Iran

Barriers and facilitators of weight management in overweight and obese people: qualitative findings of tabassom project

Since weight management is affected by various factors, including social and behavioral ones, this study aimed to explore the peoples' experience of barriers and facilitators of weight management. This qualitative content analysis was conducted as the initial step of TABASSOM Study. Participants, who tried to reduce their weight at least once, were selected by purposeful sampling method from aerobic fitness clubs, parks, and public offices in Isfahan in 2010. Data saturation was reached after indepth unstructured interviews with 11 participants. Data analysis was done by conventional content analysis method. The participants have intermittently followed weight loss program. Barriers such as physical problems, lack of motivation, lack of work and family support and lack of time have resulted in their failures and outages. The main facilitator to start or restart after stopping such programs for a while was positive psychologic effect. Findings showed that many problems could prevent weight loss. It is important to identify obstacles that hinder weight management and regimen programs and to discuss them with people before planning for their weight management.

comprehensive model to evaluate implementation of the world health organization framework convention of tobacco control

Iran is one of the countries that has ratified the World Health Organization Framework Convention of Tobacco Control [WHO-FCTC], and has implemented a series of tobacco control interventions including the Comprehensive Tobacco Control Law. Enforcement of this legislation and assessment of its outcome requires a dedicated evaluation system. This study aimed to develop a generic model to evaluate the implementation of the Comprehensive Tobacco Control Law in Iran that was provided based on WHO-FCTC articles. Using a grounded theory approach, qualitative data were collected from 265 subjects in individual interviews and focus group discussions with policymakers who designed the legislation, key stakeholders, and members of the target community. In addition, field observations data in supermarkets/shops, restaurants, teahouses and coffee shops were collected. Data were analyzed in two stages through conceptual theoretical coding. Overall, 617 open codes were extracted from the data into tables; 72 level-3 codes were retained from the level-2 code series. Using a Model Met paradigm, the relationships between the components of each paradigm were depicted graphically. The evaluation model entailed three levels, namely: short-term results, process evaluation and long-term results. Central concept of the process of evaluation is that enforcing the law influences a variety of internal and environmental factors including legislative changes. These factors will be examined during the process evaluation and context evaluation. The current model can be applicable for providing FCTC evaluation tools across other jurisdictions.

Gender differences in risk factors of obese patients after cardiac rehabilitation program

Obesity is common in patients with cardiovascular disease [CVD] and the vast majority of patients entering into cardiac rehabilitation program [CRP] are obese. Regarding the gender differences, the risk of developing coronary heart disease [CHD] is recognized to be different between obese men and women. So, the purpose of this study was to explore the effect of CRP in functional capacity [FC] and risk factors, such as obesity indexes, lipid profiles, and fasting blood sugar [FBS] in obese men and women with CHD. In an observational study between 2000 and 2011, we evaluated a total of 156 obese men and women patients with CHD who were referred to cardiac rehabilitation of Isfahan Cardiovascular Research Institute. Before and after CRP, FC and risk factors were assessed and all the participants completed this period. Data were analyzed with SPSS software version 15. For comparing the mean of outcomes, independent t tests and paired sample t tests were used. Data revealed, after CRP, obese women had significant improvement in most evaluated risk factors except total cholesterol [P = 0.05] and FBS [P = 0.09]; and obese men had favorable changes in weight [P = 0.00] and body mass index [P = 0.00], FC [P = 0.00] and total cholesterol [P = 0.02]; in spite of no significant differences in other lipid profiles. Comparing the 2 groups did not show any significant differences unless high-density lipoprotein cholesterol [P = 0.01] and low-density lipoprotein cholesterol/ high-density lipoprotein cholesterol ratio [P = 0.02] had greater improvement in obese women. We concluded that CRP is an important step initiating the process of risk reduction and restoration of FC in obese men and obese women with CHD under attendance and supervision of physician, nurse, and exercise physiologist.

[Management of an interventional community-based program based on information resulted from process evaluation: Isfahan healthy heart program]

Evaluation of interventional community-based initiatives is a basic issue for improvement and management of programs toward the goals of the health system. This paper presents the qualitative part of the process evaluation [PE] of a community-based educational program entitled Isfahan Healthy Heart Program [IHHP] conducted for prevention and control of non-communicable diseases. PE of IHHP aimed to shed insight about implementing interventions; guiding program management and corrective decision makings have been done respectively. In this qualitative survey, the study population consisted of policy-makers, managers, principal practitioners and their coworkers as well as stakeholders of IHHP. The study was directed in the same place as practicing interventional projects located in Isfahan province. It was begun in 2005 and data analysis phase was completed in 2008. The data were collected through conducting interview with a purposive sample of 60 participants and were analyzed using qualitative content analysis method. Qualitative data were categorized in several headings. Four of the most important headings were as experiences of resources, attitude towards interventions, motivating factors and consistent partnership. Emphasizing on usefulness of qualitative data in process evaluation of IHHP, findings of the present study disclosed some of the effective underpinning factors that the most important of them was described as [executive level human factors]. The study findings emphasized on the vital role of the resources, nevertheless [accepting] the used resources as well interventions specifically on behalf of managers and executive agents were primarily affected by their humanistic qualities such as attitude and willingness to moving towards aimed change. Accepting the program in behalf of users, specifically executive agents, must be considered in such a vast community-based educational program